Malpractice Risk Among US Pediatricians

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Despite evidence on how malpractice risk varies according to physician specialty, there is growing but still limited evidence about malpractice among US pediatricians. The frequency of malpractice claims against pediatricians is low among specialties, but payments are among the highest. WHAT THIS STUDY ADDS:This study describes malpractice risk among US pediatricians using data from a nationwide liability insurer covering 1630 pediatricians from 1991 to 2005. It compares pediatric malpractice experience with other specialties and studies patient factors associated with pediatric malpractice claims. abstract OBJECTIVE: To characterize malpractice risk among US pediatricians. METHODS:We analyzed malpractice claims of all pediatricians and other physicians covered by a nationwide liability insurer from 1991 to 2005 (n = 1630 pediatricians; 40 916 total physicians). We characterized annual malpractice risk among pediatricians compared with other physicians. We characterized claims according to patient age, injury type, months required to resolve the claim, and whether an indemnity payment was made. We estimated how patient age and injury type were associated with whether a claim resulted in payment to a patient (and if so, payment size) and the time required to resolve the claim. RESULTS:The annual percentage of pediatricians facing a malpractice claim was 3.1% (7.4% among other physicians, P , .001). Among 404 claims, 83 (20.5%) resulted in an indemnity payment and 15 (3.7%) resulted in a payment exceeding $1 million. Annual rates of indemnity were lower among pediatricians (0.5%) than other physicians (1.6%, P , .001), whereas rates of payments exceeding $1 million were similar (0.13% among pediatricians and 0.11% among other physicians, P = .57). The mean indemnity payment was $562 180 (SD $667 962). Cases with permanent injury (n = 172) had larger mean payments ($703 373) compared with fatalities ($559 102; n = 131) or temporary or psychological injuries ($127 663; n = 101), P , .05. The mean time to resolution was 23.4 months (SD 21.8 months).CONCLUSIONS: Indemnity payments among pediatricians are infrequent but large, particularly in cases with permanent patient injury rather than death or temporary injury. The time required to resolve claims may be considered to be long.